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NPI Code Detail

MEDICARE: BEREA AREA DEVELOPMENT LLC

MEDICARE: BEREA AREA DEVELOPMENT LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility100737KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225027840
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEREA AREA DEVELOPMENT LLC
Provider Business Mailing Address
First Line : 300 PROVIDER CT
Second Line : SUITE 100
City : RICHMOND
State : KY
Zip : 40475-8488
Country : US
Telephone Number : 859-623-0898
Fax Number : 859-623-0843
Provider Business Practice Location Address
First Line : 1043 BROOKLYN BLVD
Second Line :
City : BEREA
State : KY
Zip : 40403-1090
Country : US
Telephone Number : 859-228-0551
Fax Number : 859-228-6334
Authorized Official
Title or Position : VP OF ADMINISTRATIVE SUPPORT
Name : MRS. KIMBERLY MORROW
Credential :
Telephone Number : 859-623-0898
Provider Enumeration Date : 10/17/2005
Last Update Date : 04/30/2013

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Directions to “BEREA AREA DEVELOPMENT LLC ” Practice Location

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